Provider Demographics
NPI:1679156905
Name:WINGROVE-QUARANTA, HARRIET (MD)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:WINGROVE-QUARANTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 WIDEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:WEWAHITCHKA
Mailing Address - State:FL
Mailing Address - Zip Code:32465-8310
Mailing Address - Country:US
Mailing Address - Phone:850-387-5313
Mailing Address - Fax:
Practice Address - Street 1:HCA FLORIDA GULF COAST HOSPITAL
Practice Address - Street 2:449 W 23RD ST
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-769-8341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC390200000X
FLME165173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program